The share of employers covering glucagon-like peptide-1 (GLP-1) drugs for weight management fell from 72% in 2025 to 60% in 2026, and the retreat is picking up pace. New data from Business Group on Health show that 14% of employers have already dropped or plan to drop GLP-1 weight management coverage by 2027. Earlier this year, that figure stood at 10%.
Starbucks put a name on the trend in August. The company confirmed it will stop covering GLP-1 medications prescribed for weight loss for benefits-eligible employees starting in October. Coverage continues when the same drugs are prescribed for diabetes or other approved conditions. The change affects workers logging at least 20 hours per week.
The pullback is not a judgment on whether GLP-1s work. It is a judgment on what they cost.
At the end of the day, the biggest issue is cost," Eileen Pincay, pharmacy practice leader at benefits consultancy Segal, told SHRM. "GLP-1s work, employees want them, and they're extremely expensive."
Brand-name injectables typically run between $1,000 and $1,500 a month for consumers, with employers potentially covering 70% to 100% of that. According to Business Group on Health's survey of 127 employers representing 8.7 million covered lives, pharmacy now represents 25% of employers' total healthcare spend, and drug costs are projected to rise 12%.
Not every employer dropping coverage is making a clean exit. Pincay said some plans are holding coverage while tightening eligibility through higher body mass index thresholds or stricter clinical criteria. Brenna Shebel, vice president at Business Group on Health, described the shift as one of scrutiny rather than retreat.
"The result is greater scrutiny of every healthcare dollar spent," Shebel told SHRM.
With open enrollment approaching in November, the coverage decisions employers made earlier this year reach employees in the coming weeks. Clients who dropped GLP-1 weight management coverage need to explain the change clearly and in advance, not just note it in a summary plan description.
The communication issue is specific. GLP-1 drugs have a high public profile, and employees using them under a weight management benefit will face a sharp cost shift. From plan-covered to out-of-pocket at $1,000-plus a month is a gap large enough to generate workforce friction if it arrives without warning or context.
The coverage structure Starbucks is using, retaining the drug for diabetes and cardiovascular indications while ending it for weight loss, is a middle path other employers have adopted. It preserves some clinical access while containing the highest-volume cost driver
Twenty-four percent of Business Group on Health respondents said they have never offered GLP-1 weight management coverage and are not considering it. A further 3% are considering coverage for 2028 or 2029. That leaves a segment still in the market, and for those employers, the direction is structured coverage with utilization controls.
Employers retaining coverage are adding prior authorization requirements, tightening eligibility thresholds, and exploring direct-to-employer drug arrangements that bypass the pharmacy benefit manager. Those structures require plan document review and carrier or PBM coordination that typically runs through the broker.
